Reports 2005

Since the genesis of the recovery ‘movement’ in New Zealand, over 20 years ago there has been an explosion of recovery philosophies, models and strategies within mental health services.  Although the government’s policies for mental health services have begun to incorporate mental health recovery within the UK, recovery is still a relatively new idea.  Understandably, there is currently much uncertainty upon which model of care or approach would be effective, leaving more questions than answers concerning how to set up recovery oriented services and practices.

This work results from a travel scholarship to visit mental health services for asylum seekers and refuges in Canada and the United States of America.  The aim was to discover what treatment approaches work and what has been attempted in dealing specifically with the mental health needs of asylum seekers and refugees.

A significant proportion of individuals with HIV infection are also co-infected with Hepatitis C virus (HCV) due to shared routes of transmission.  Chronic HIV is associated with increased morbidity and mortality from specific HIV-related illnesses, whilst chronic HCV is a major cause of liver disease.  In addition, co-infected individuals face issues associated with negative perceptions about themselves and their illness.  Current research concerning co-infection is dominated by a biomedical focus on disease, with little attention paid to the individual’s experience of illness.

It has been observed in various studies that knowledge about the effects of brain injury is poor among the general public, however, the knowledge of health professionals who provide care for the brain injured in an acute hospital setting has not been investigated.

The aim of this assignment is to examine the literature pertaining to oral care in the critically ill patient.  In recognising the importance of oral care, nurses may realise the gravity of poor oral care for the patient and understand that high quality oral is essential in improving patient outcomes.

Today, nurses are more likely to utilise evidence in everyday practice; therefore, it is important to explore and understand all aspects of nursing with regard to Evidence Based Clinical Practice. 

Many children and young people, for numerous and varied reasons, are unable to remain in the care of their families.  These children are known as “Looked After Children” (L.A.C.) and either voluntarily, or as a result of a legal order are in the care of local health & social service authorities.  The D.O.H. (2002) states that these children are amongst the most socially excluded groups in society.  They have profoundly increased health needs, which often remain unmet resulting in poor health, educational and social outcomes.

Organisations have a culture, which can be individualised to themselves.  It can be at a broad, national level, e.g.:  the NHS; regional, e.g.:  SHA; or local, e.g.:  Trusts.  At local level, there may be little similarity to the neighbouring Trust of how successful they are regarding performance.

The United Kingdom has one of the highest teenage pregnancies in the developed world, second only to the USA and almost five times higher than the Netherlands and Sweden (UNICEF, 2001).  Of 950,000 teenage pregnancies that occur each year, more than 3 out of 4 are unintended (Gutmacher 2002).

The Netherlands and Nordic countries are seen as having a comprehensive and more open delivery of sex education providing necessary information from a much more positive sexual health promotion stance.

Facilitating Thrombolysis as a treatment for acute stroke in District General Hospitals (DGHs) in the UK. 

This was a three-week study tour to enable the process of offering this specific treatment for stroke patients to become apparent.  Two weeks were spent at Foothills Medical Centre, Calgary, Canada.  A day visit was made to several facilities in the UK, namely:  St. Georges Hospital, Tooting; The National Hospital, Queens Square; The Royal Bournemouth and Christchurch NHS Foundation Trust (Bournemouth site) and to Surrey Ambulance Headquarters, Banstead, Surrey.  Additionally, Scarborough Hospital was contacted by phone.

This study explores the concept that the prevalence of type two diabetes is intensifying world-wide.  It attributes one of the main causes to be the fact that obesity is increasing to epidemic proportions.  Within the study the current situation and the rationale for change will be considered.

Effective communication in healthcare is central to good and ethical practice.  For health care professionals at all stages of their professional careers, the ability to develop and maintain competence and confidence in communicating with “real” patients and situations is essential.

Simulated patients are people who act the role of patients, relatives or health and social care professionals.  They are an integral part of health care professionals’ training and seen as complementing and supporting the acquisition of clinical communication skills.

Skill mix and role redesign have changed the face of the primary care workforce in the UK in recent years.  In areas with minority ethnic communities, support workers with language skills and cultural knowledge have been employed to provide health care.  Although this role is relatively new to the UK, countries like Pakistan have a long history of employing community support workers.  This study seeks to learn from Pakistan’s experience and apply the learning to the UK context with particular reference to the field of pre-school nutrition.

Maturity Onset Diabetes of the Young (MODY) is a genetic sub type of diabetes accounting for 1-2% of diabetes in the UK or around 20,000 people, and 69% is caused by a mutation in the HNF-1a gene.  The condition has an autosomal dominant inheritance pattern with the mutation being highly penetrant.  By the age of 40, 90% of affected individuals will have developed diabetes.  The age of onset is usually before the age of 25 years and therefore subjects have lifelong exposure to hyperglycemia.

The aim of this study, based on a visit to early intervention services in Western Australia operating in rural areas was to:

1. Work alongside early intervention nurse practitioners to identify effective methods/systems of identifying individuals with a first episode of psychosis earlier
2. To raise the profile of providing early intervention to rural communities both at a local and national level in the UK
   

The purpose of the travel scholarship was to visit the USA to explore the use of Equine Assisted Therapy with children and young people exhibiting challenging behaviour.

Children who have behavioural disorders such as oppositional defiant disorder often find themselves adversely placed within the criminal justice system.   Practitioners who work with these young people often struggle to find an appropriate methodology for engaging and ultimately treatment.

I was awarded The Sandra Charitable Trust Travel Scholarship 2005 for the study of nursing practice to Explore and evaluate conservative management options for severe chronic functional bowel disorders. The scholarship was granted to support a five-week travel sabbatical to meet the objectives outlined in the application proposal.

The chosen study itinerary included travel to two destinations in North America: Chicago and Fort Lauderdale, and to three destinations in Europe:  Amsterdam, Holland, and Copenhagen and Aarhus in Denmark.

This paper will explore the aims, outcomes and benefits of the tour.
The aims of the study were:

1.  Examination of best practice in relation to infant mental health services used in primary and secondary care

2.  Exploration of approaches used in promoting infant mental health within families in the UK and Australia

3. Comparison of provision of services ran by primary/secondary care staff in the UK and Australia

4. Investigation of the role of the nurse in multi-agency provision of infant mental health services
   

The generosity of the St Mary’s Hospital Past and Present Nurses’ League in support of this Florence Nightingale Foundation Travel Scholarship enabled an analysis of the different approaches to teaching child health in pre-registration nurse education in the UK and Canada and the development of recommendations which draw on the strengths of each approach.

The scourge of childhood which blighted young lives a century ago when the first register of children’s nurses was established have mostly been conquered but they have been replaced by new challenges which registered nurses must manage in caring for the health of children and young people.

The diagnosis and treatment of cancer is known to cause the patient and their family considerable psychological distress, despite ongoing progress in cancer management.  Furthermore, patients diagnosed with head and neck cancer have not only the potential of a premature death which is synonymous with cancer, but the reality of visible disfigurement and changes to many basic functions of life such as speech, swallowing and breathing.

Agitation is considered as one of the most distressing symptoms in the dying patient and profoundly affects family members (Brajtman 2003).  It is a very difficult symptom to manage due to the vast diversity in patients and their significant others.  Unlike the management of pain for example, terminal agitation is a symptom that can only truly be assessed after death.

New Labour’s flagship legislation the Crime and Disorder Act 1998 introduced the Anti-social Behaviour Order (ASBO), to combat low level but persistent crime and disorder in areas of high deprivation.  It has rapidly developed into a highly visible tool to tackle both troublesome and criminal behaviour of children and young people.

Reports on the health of the public in Britain have shown that sexual ill heath is unequally distributed across society.  People from socially disadvantaged and marginalized groups experience the highest levels of sexually related illness.  Minority ethnic populations have been shown to suffer disproportionately from sexual ill health.  Strategies which have succeeded in reducing the rates of unintended pregnancy or sexually transmitted infections in majority populations have had less success in minority ethnic communities.  Community based initiatives are seen as a possible way forward in improving the health chances of minority ethnic people in UK society.

This is a qualitative, exploratory, descriptive study to investigate a pulmonary rehabilitation programme and the follow-on care provided by a local Health Care Trust.  The primary aim of the study is to investigate the participants’ perception of the service provided.  In addition, the concept of follow-on care is explored with key stakeholders involved in service planning and provision.

The use of IT in nursing (nursing informatics) is increasing, and has the potential to improve patient care.  Research, and the experience of the author, has shown however that nurses lack basic IT skills and informatics knowledge.  This study sought to explore what nurses’ want from IT in the workplace, and how pre-registration education can help to prepare nurses for working in this changing environment.

Historically alcohol detoxification has taken place in hospital settings, either general hospital, psychiatric admission wards or specialised detoxification/treatment centres.

In the current climate of joint working between statutory and non-statutory services, a window of opportunity has opened in the treatment of addiction.  In Sperrin Lakeland Trust a joint project has commenced with First Housing, Supporting People and the Trust to offer a service for chronic drinkers in the community.  The project, named Ramona House, consists of four beds for detoxification/crises and four beds for long/medium stay.

Nurse education has traditionally relied on clinical placements to provide the students with the “hands on” skills experience that is not possible to teach in a classroom setting.  However with changes to the NHS this is becoming increasingly difficult with fewer resources available and issues of patient safety to consider.

As technological advances have been made and more becomes known about cystic fibrosis the quality of life of patients suffering from this debilitating disease is improving.  However, with this increased technology and more advanced care, new problems are surfacing with increased vigour due to the increased longevity exhibited in patients.  One of these complications manifesting itself with increased frequency is diabetes mellitus.

Nurses throughout all specialties are taking on more extended roles.  For oncology research nurses, a logical progression is to become the initial signatory when taking consent to clinical trials, a practice currently undertaken by medical staff involved in the trial.  Oncology Research Nurses currently participate in the informed consent process and act as a main contact for the patients participating in clinical trials, but do not sign the consent form with the patient.  The informed consent process is closely regulated to ensure patient safety, but enabling nurses to extend their role in this way may enable a more flexible service for patients.

Acquired Brain Injury (ABI) can be a debilitating condition that affects both patient and family members.  The recovery and rehabilitation process can be challenging in many ways for the patient, familiy, and professionals alike.